Provider Demographics
NPI:1457346116
Name:STEDMAN, ELIZABETH ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:STEDMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1883 W MONROE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MI
Mailing Address - Zip Code:48880-8702
Mailing Address - Country:US
Mailing Address - Phone:989-681-2533
Mailing Address - Fax:989-681-2533
Practice Address - Street 1:1883 W MONROE RD
Practice Address - Street 2:SUITE B
Practice Address - City:SAINT LOUIS
Practice Address - State:MI
Practice Address - Zip Code:48880-8702
Practice Address - Country:US
Practice Address - Phone:989-681-2533
Practice Address - Fax:989-681-2533
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005733111N00000X
MIES005733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B95209OtherBCBS
MI2849354Medicaid
MI2849354Medicaid
MIU36450Medicare UPIN